PHOTOS: Alberta Health Services, as originally envisaged by the Tories and described by the Wildrose Party. Below: Another AHS reorganization as seen by the NDP. Below that train wreck, Alberta Health Minister Sarah Hoffman.

Alberta’s two right-wing opposition parties are said to be in a lather because of Health Minister Sarah Hoffman’s announcement yesterday the former PC government’s so-called decentralization of Alberta Health Services is no more.

Well, it’s part of the job of being an opposition MLA to gin up a little fake outrage now and again, so one can hardly blame the Wildrosers and the tattered remnants of the once mighty Tories for giving it their best effort.

The Wildrosers, who are the official opposition, painted a picture of rural Alberta betrayed, which of course is mere hot air. Rural voters are quite intelligent enough, thank you very much, to understand their quite justified unhappiness with the 2008 centralization of the province’s health regions into the monolithic Alberta Health Services would not have been fixed by the Tories’ so-called reorganization.

The Tories themselves, who haven’t yet quite figured out yet how to do opposition, pointed to real problems with the centralization disaster that they perpetrated all by themselves and claimed the plan they rolled last March would have fixed it, which is laughable when you look at what they were really proposing.

The new NDP government, speaking through Ms. Hoffman, suggested sensibly enough that the province’s health care system couldn’t stand another major reorganization just now without practically coming apart at the seams, an assessment almost everyone inside the health care system fears might just be true.

“Every time you have a system change, it creates more chaos and struggle,” Ms. Hoffman said. “We want to make sure that we’re providing stability.”

Obviously, it suits everyone in the Kabuki play that is parliamentary politics to pretend that the so-called reform introduced by the Tories was a real decentralization that would have had actual costs and consequences, the pros and cons of which can be sensibly debated.

It suits the opposition parties because they’d like to do what they can to stir up resentment against the NDP in rural areas by pretending Premier Rachel Notley’s new government has taken away something valuable.

It suits the government because it would like to make the case that Tory and Wildrose politicians, who were still all in one party in 2008, want to make the disaster they perpetrated back then even worse, and to offer a concrete illustration that they’re doing something about it.

As for the media, they have always reported the former government’s press releases at face value and they continue to do so, which is evidence of either a conspiracy or an incapacity to engage in simple observation and report on it.

But while Ms. Hoffman is almost certainly right that there is little or nothing to be gained at this fraught moment in history by any reorganization of AHS, it is important to remember that the plan proposed by the PCs was entirely cosmetic in nature, and that it would be fair to describe the entire scheme as not much more than a deception.

As was reported in this space back on March 23, when you actually looked at the few details of Tory plan, AHS was not going to be dismantled, Alberta was not going to return to regional health authorities, and it was highly unlikely that any significant decisions about health care would ever be made at the local level if the PC plan had been implemented.

The PC Government’s March 18 news release – intentionally, it is said here – left a lot of readers with the false impression the scheme would mean restoration of regional health authorities, which were eliminated in 2008 when AHS was created by the government of premier Ed Stelmach.

A lot of those misguided readers, who apparently included journalists like the writer of the Canadian Press headline that said, “Back to the past: Alberta returns to decentralized health care,” fell for this fairy tale.

The reality is that AHS decision-making mechanisms were never going to be decentralized. All that was supposed to happen was that AHS’s five “zones” would have been renamed and insignificantly restructured into eight to 10 “districts,” including the same two giant urban jurisdictions in Edmonton and Calgary.

Oh, and there would be some local advisory boards, which would have had no power but have been a nice place to reward some PC Party loyalists with opportunities to claim for “expenses.”

As for AHS, it would have remained exactly the same under the PC restructuring the opposition parties are now complaining about losing – that is to say, legally the province’s single health authority – as it now will under the NDP. Alberta Health Services communications officials admitted this at the time if you asked them the right question directly.

The real advantage of yesterday’s NDP decision is that it will save money that would have been hosed away on meaningless and cynical cosmetics by the Tories in their doomed effort to steal votes from the Wildrose Party by fooling a few rural voters.

That is a small thing in light of the vast amounts of money that have gone heaven knows where during the nearly 44 years of Tory misrule in Alberta, but it is worth the effort nevertheless.

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  1. With all due respect, I disagree with your take on this issue. The rural health review panel (one of whose members was CARNA President Dr Shannon Spenceley of Lethbridge) made a total of 56 recommendations; in the area of Accountability, it said,

    “1) Re-launch AHS as a cohesive health care service delivery agency with province-wide standards and expectations delivered through locally autonomous districts. Establish which functions will remain controlled and managed centrally.

    2) Respecting historical travel and trading patterns, establish 8-10 health districts and corresponding Health Advisory Councils with clear mandates and responsibilities. Develop clear and direct reporting structures and establish expectations for communication and feedback with stakeholders.

    3) Empower local site managers with full authority over all day-to-day operations of their facilities and direct accountability, communication and reporting to District Directors.

    4) Establish a clear path of communication and feedback for patients, families, caregivers and community members to address concerns quickly and effectively.”

    This does not mean dissolving AHS and recreating the old RHAs, just fixing its problems. This could have been implemented thoughtfully and with a minimum of disruption. But the previous government did not accept these recommendations in this level of detail, and said nothing about the other recommendations. I feel the report should be implemented in its entirety, not piecemeal. (This is an area where I part ways with the new government).

  2. Jerry: I don’t disagree that helpful points were made by the rural health review panel or that some of the participants were knowledgeable, well-intentioned and thoughtful. My issue is not with the review, but with the bogus policy brought forward by the former Prentice government, which was cosmetic and designed to fool voters long enough to slip back into power one last time. The government press release was openly – and obviously intentionally – deceptive, giving the impression health regions were being put back into operation. The media took the bait hook, line and sinker. No one from AHS or the government phoned them up to say, “whoops, you got it wrong.” No, they let the false impression linger, because that was the aim of the publicity. Perhaps they would have implemented more recommendations later, after reelection – more likely not. Regardless, there is no evidence this scheme as put forward by the Tories was anything but a political re-branding exercise.

  3. As you say, this is all just inconsequential tinkering (or really deciding not to engage in inconsequential tinkering). This is perhaps necessary, but woefully insufficient. The bigger issue is that the NDP has no health plan other than to not enact the Prentice cuts (and no, banning menthol cigarettes is not even 0.01% of a plan). Health care costs continue to rise incessantly without a corresponding increase in population health status–all the while crowding out investment in social services, infrastructure, and education. This is happening before the baby boomers become heavy health care users–an event that will surely deliver a catastrophic blow to the already stretched health care system. What is the NDP plan for this other than more money (which is a plan that hasn’t worked to this point and further increases will be needed to just address the aging population in any case–leaving little to actually fix the system)? Where are the ideas for public health or primary care? Where are the ideas to decrease demand, rather than to trying again and again unsuccessfully to match supply to insatiable demand? Where is the acknowledgement that senior nurses in Alberta are in the top 10% of Canadian income earners, or that doctors are well into the top 1%? Say what you want about the Tories, but the PCNs were at least an idea (albeit underfunded). Say what you want about Redford, but the FCCs were at least an idea (albeit redundant to the PCNs they may have solved the funding issue). Theoretically, and NDP government would at least help address the social determinants of health, but their continued commitment to ever rising health care costs will handicap their ability to do so.

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